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WO2004110318A2 - Insert for a cotyloid implant cup for a joint prosthesis, cotyloid implant and joint prosthesis - Google Patents

Insert for a cotyloid implant cup for a joint prosthesis, cotyloid implant and joint prosthesis Download PDF

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Publication number
WO2004110318A2
WO2004110318A2 PCT/FR2004/001410 FR2004001410W WO2004110318A2 WO 2004110318 A2 WO2004110318 A2 WO 2004110318A2 FR 2004001410 W FR2004001410 W FR 2004001410W WO 2004110318 A2 WO2004110318 A2 WO 2004110318A2
Authority
WO
WIPO (PCT)
Prior art keywords
shell
lining
insert
insert according
interior space
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/FR2004/001410
Other languages
French (fr)
Other versions
WO2004110318A3 (en
Inventor
Serge Calamel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biotechni
Original Assignee
Biotechni
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Biotechni filed Critical Biotechni
Priority to DE602004004115T priority Critical patent/DE602004004115T2/en
Priority to US10/559,680 priority patent/US8556984B2/en
Priority to EP04767276A priority patent/EP1631219B1/en
Publication of WO2004110318A2 publication Critical patent/WO2004110318A2/en
Publication of WO2004110318A3 publication Critical patent/WO2004110318A3/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4081—Glenoid components, e.g. cups
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
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    • A—HUMAN NECESSITIES
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A61F2002/3453—Acetabular cups having a non-hemispherical convex outer surface, e.g. quadric-shaped
    • A61F2002/3462—Acetabular cups having a non-hemispherical convex outer surface, e.g. quadric-shaped having a frustoconical external shape, e.g. entirely frustoconical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A61F2002/3453—Acetabular cups having a non-hemispherical convex outer surface, e.g. quadric-shaped
    • A61F2002/3466—Acetabular cups having a non-hemispherical convex outer surface, e.g. quadric-shaped having a cylindrical external shape, e.g. entirely cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611—Heads or epiphyseal parts of femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4018—Heads or epiphyseal parts of humerus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0067—Three-dimensional shapes conical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C43/00—Compression moulding, i.e. applying external pressure to flow the moulding material; Apparatus therefor
    • B29C43/02—Compression moulding, i.e. applying external pressure to flow the moulding material; Apparatus therefor of articles of definite length, i.e. discrete articles
    • B29C43/18—Compression moulding, i.e. applying external pressure to flow the moulding material; Apparatus therefor of articles of definite length, i.e. discrete articles incorporating preformed parts or layers, e.g. compression moulding around inserts or for coating articles

Definitions

  • the invention relates to the field of joint prostheses, such as hip or shoulder prostheses.
  • hip prostheses composed, on the one hand, of a metal rod and of a ceramic femoral head of substantially spherical shape that the surgeon replaces the upper part of the patient's femur, and, d on the other hand, a cotyloid implant intended to receive said femoral neck, and which the surgeon implants, for example by sealing, in the patient's pelvis at the location of the natural acetabulum.
  • the acetabular implant consists of two parts:
  • the insert is preferably made of ceramic so as to have the best resistance to wear during movements of the femoral head in the acetabular implant. But these ceramic inserts are relatively expensive. We may therefore wish to reserve their employment for young patients. For older patients, we may prefer to use polyethylene inserts, which are less resistant to wear, but cheaper. The latter solution is however not satisfactory.
  • the assembly between the metal cup and the polyethylene insert is effected by impaction, the shell having a conical bearing, associated with different fixing means. However, a sufficiently firm hold of the insert in the cup is not obtained. There are still possibilities of micro-movements between the two parts. These micro-movements cause the detachment of polyethylene particles which penetrate into the screw holes and come into contact with the bone. This generates osteolysis and, in the long run, loosening of the acetabulum by degradation of the bone-metal contact surface.
  • the object of the invention is to propose a new configuration of acetabular implant for total hip prosthesis, authorizing the use of a polyethylene insert associated with a metal cup, without the above-mentioned drawbacks.
  • the subject of the invention is an insert for an acetabular implant cup cup for a joint prosthesis, of the type comprising a metal shell and a polymer lining of the interior space of said shell, a receptacle for a prosthetic head being provided. on the lining, said shell having, on its interior space, means for preventing extraction of said lining from the shell and means for preventing rotation of the lining in the shell, characterized in that said means for preventing extraction of the lining have a stud disposed on the bottom of the shell and having at least one groove or lip.
  • Said means for avoiding extraction of said lining can comprise at least one lip.
  • Said means for preventing extraction of said lining may include at least one groove.
  • Said means for preventing rotation of the lining may include bosses formed on the surface of the wall delimiting the interior space of the shell.
  • Said bosses may be ribs extending over all or part of the height of the interior space of the shell.
  • Said means for preventing rotation of the lining may include depressions formed on the surface of the wall delimiting the interior space of the shell.
  • Bumps can be made on the lip.
  • Depressions can be provided on the lip.
  • the front part of said shell may have a taper.
  • the wall of the receptacle can be coated with ceramic.
  • Said lining can be obtained by a thermocompression operation of said polymer in said interior space of the shell followed by machining.
  • Said packing can be obtained by prior shaping and be put in place by impaction in the shell.
  • the invention also relates to an acetabular implant of the type comprising a cup intended to be fixed in the pelvis or the scapula of a patient and an insert lining the interior of said cup to receive a prosthetic head, characterized in that the insert is of the previous type.
  • the invention also relates to a joint prosthesis of the type comprising an acetabular implant and a prosthetic head, characterized in that said implant is of the preceding type.
  • the invention firstly consists in providing an insert comprising two parts: - a basic metal shell;
  • Anchoring means such as lips and / or peripheral and transverse grooves, formed in the metal shell make it possible to ensure total immobility of the polyethylene in the metal. This avoids friction which may cause the release of polyethylene particles into the environment of the insert.
  • an essential element of these anchoring means is a stud disposed in the bottom of the shell, and having a groove or a lip.
  • FIG. 1 which shows seen from the front (fig.ia) and from above (fig.ib) an example of a metal shell forming part of an insert for acetabular implant according to the invention
  • the metal shell (generally made of stainless steel or titanium) 1 has a frustoconical external shape (in the example shown) or spherical in its rear part 2, and a substantially cylindrical shape in its front part 3.
  • this front part 3 has a slight conicity which, when the cup is in place in the patient's pelvis or scapula, contributes to keeping the shell 1 in place.
  • This shell 1 is intended to be placed in a cup metallic (not shown), itself fixed in the patient's pelvis or scapula by sealing or screwing.
  • the interior space 4 of the shell 1, in the example shown is of frustoconical shape in its rear part 5, and of cylindrical shape in its front part 6. These shapes could, as a variant, be respectively spherical (for example) and tapered.
  • the periphery of the front part 6 of the interior space 4 of the shell 1 has a raised lip 7, itself provided with depressions 8 and bosses 9. Furthermore, according to the invention, the bottom 10 of the part rear 5 of the interior space 4 of the shell 1 has a stud 11 of substantially cylindrical shape, the side wall of which is provided with a groove 12, as shown, and / or a lip in relief, or several such grooves 12 and / or lips.
  • the insert for acetabular implant according to the invention one begins by manufacturing a metal shell of the type which has just been described. Then its interior space is filled with polyethylene (or another polymer capable of being suitable for this type of implant) by a thermocompression process, that is to say hot injection under pressure. The polyethylene is also made to extend beyond the upper edge 13 of the shell 1. Then the lining 14 is made of polyethylene thus obtained so as to give it a shape which will allow it to receive the head of the hip prosthesis or shoulder of which the acetabular implant according to the invention will form part.
  • FIG. 2 represents the shell 1 and its lining 14 made of polyethylene after machining.
  • the lining 14 remains permanently in the shell 1.
  • the raised lip 7 has precisely the function of preventing the extraction of the lining 14 after it has been produced, in particular when using the implant according to the invention.
  • a groove 15 is formed on the outer periphery of the lining 14, in line with the lip 7. The lip 7 therefore penetrates into the lining 14 and prevents any movement of the lining 14 which would tend to extract it from the shell 1.
  • the stud 11 has a similar function. During thermocompression, the polyethylene is molded around it, and the presence of the groove 12 (respectively of a lip) provides a possibility of attachment of the lining 14 on the stud 11, by formation on the lining 14 of a raised lip 16 (respectively of a groove) in line with the groove 12 (respectively of the lip) of the pad 11. The presence of this pad 11 provides fully effective resistance to the extraction of the lining 14 and completes the effect of other anti-extraction elements. It can even possibly constitute the only anti-extraction element
  • the lip 7 can be continuous over the entire periphery of the interior space 4 of the shell 1, or be discontinuous. There may be several, distributed at different levels of the interior space 4 of the shell 1. It could be replaced by one or more grooves which would create a corresponding relief on the lining 14 during thermocompression. However the lip 7 is the preferred configuration for the anti-extraction means other than the stud 11. In fact the polyethylene, after thermocompression, undergoes a shrinkage of 1.8%. This withdrawal tends to strengthen the attachment of the lining 14 to the shell 1 if the latter has a lip 7, while a groove would tend to degrade this attachment. Of course, lips and grooves can be combined. This effect of strengthening the attachment by the withdrawal of the polyethylene is also very sensitive at the level of the pad 11, and, precisely, the shape of the pad 11 makes it possible to take advantage of this effect in an optimal manner.
  • the anti-rotation means it is possible to provide only depressions 8, or only bosses 9, and to arrange them in places other than the lip 7 on the surface of the wall delimiting the interior space 4 of the shell 1.
  • the bosses 9 are preferred. They may have the form of ribs extending over all or part of the height of the interior space 4 of the shell 1. As can be seen in FIG.
  • the machining of the lining 14 after thermocompression makes it possible to spare d on the one hand a rim 17 resting on the upper edge 13 of the shell 1, and above all a receptacle 18 of spherical shape intended to receive heads of different materials (ceramic or metallic) from the hip or shoulder prosthesis to which the the acetabular implant according to the invention is intended to be integrated.
  • the contact between the insert and the head of the prosthesis if the latter is ceramic, is a ceramic-ceramic contact which avoids any release of polyethylene into the environment of the prosthesis.
  • the lining 14 is produced not by thermocompression in the shell 1, but by a shaping operation (molding and / or machining for example) carried out outside the shell 1.
  • the positioning of the lining 14 in the shell 1 is then carried out by impaction in the shell 1, the lining 14 having hollows and reliefs complementary to the reliefs and hollows present on the interior space 4 of the hull 1.
  • a final machining of the lining 14 after its setting place allows, if necessary, to adjust the external dimensions.
  • a ceramic coating can be added to the receptacle 18.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The invention relates to an insert for a cotyloid implant cup for a joint prosthesis, of the type comprising a metal shell (1) and a polymer fitting (14) for the internal region (4) of said shell (1), with a housing (18), for a prosthetic head machined on the fitting (14), said shell having, on the inside thereof (4), means to prevent an extraction of said fitting (14) from the shell (1), characterised in that said means for preventing an extraction of the fitting comprises a socket (11), arranged on the base (10) of the shell (1), having at least one groove (12) or a lip. The invention further relates to a cotyloid implant with a cup and insert of the above type and a joint prosthesis of the above type with a cotyloid implant as above and a prosthetic head.

Description

Insert pour cupule d'implant cotyloïdien pour prothèse articulaire, implant cotyloïdien et prothèse articulaire. Insert for acetabular implant cup for joint prosthesis, acetabular implant and joint prosthesis.

L'invention concerne le domaine des prothèses articulaires, telles que les prothèses de hanche ou d'épaule.The invention relates to the field of joint prostheses, such as hip or shoulder prostheses.

Il est classique d'utiliser des prothèses de hanche composées, d'une part, d'une tige métallique et d'une tête fémorale en céramique de forme sensiblement sphérique que le chirurgien substitue à la partie supérieure du fémur du patient, et, d'autre part, d'un implant cotyloïdien destiné à recevoir ledit col fémoral, et que le chirurgien implante, par exemple par scellage, dans le bassin du patient à l'emplacement du cotyle naturel.It is conventional to use hip prostheses composed, on the one hand, of a metal rod and of a ceramic femoral head of substantially spherical shape that the surgeon replaces the upper part of the patient's femur, and, d on the other hand, a cotyloid implant intended to receive said femoral neck, and which the surgeon implants, for example by sealing, in the patient's pelvis at the location of the natural acetabulum.

Dans un exemple connu d'une telle prothèse, l'implant cotyloïdien se compose de deux pièces :In a known example of such a prosthesis, the acetabular implant consists of two parts:

- une cupule métallique fixée dans le bassin à l'emplacement du cotyle naturel au moyen de ciment ou de vis ;- a metal cup fixed in the basin at the location of the natural acetabulum by means of cement or screws;

- et un insert venant garnir l'intérieur de la cupule, destiné à recevoir la tête fémorale de la prothèse et présentant une forme correspondant à celle de la tête fémorale.- And an insert lining the interior of the cup, intended to receive the femoral head of the prosthesis and having a shape corresponding to that of the femoral head.

L'insert est, de préférence, réalisé en céramique de façon à présenter la meilleure résistance à l'usure lors des mouvements de la tête fémorale dans l'implant cotyloïdien. Mais ces inserts céramiques sont relativement coûteux. On peut donc souhaiter réserver leur emploi au cas de patients jeunes. Pour les patients plus âgés, on peut préférer utiliser des inserts en polyéthylène, certes moins résistants à l'usure, mais meilleur marché. Cette dernière solution n'est cependant pas satisfaisante.The insert is preferably made of ceramic so as to have the best resistance to wear during movements of the femoral head in the acetabular implant. But these ceramic inserts are relatively expensive. We may therefore wish to reserve their employment for young patients. For older patients, we may prefer to use polyethylene inserts, which are less resistant to wear, but cheaper. The latter solution is however not satisfactory.

L'assemblage entre la cupule métallique et l'insert en polyéthylène s'effectue par impaction, la coque présentant une portée conique, associée à différents moyens de fixation. Mais un maintien suffisamment ferme de l'insert dans la cupule n'est pas obtenu. Il subsiste des possibilités de micro-mouvements entre les deux pièces. Ces micro-mouvements provoquent le détachement de particules de polyéthylène qui pénètrent dans les trous de vis et viennent au contact de l'os. Cela engendre des ostéolyses et, à la longue, le descellement du cotyle par dégradation de la surface de contact os-métal.The assembly between the metal cup and the polyethylene insert is effected by impaction, the shell having a conical bearing, associated with different fixing means. However, a sufficiently firm hold of the insert in the cup is not obtained. There are still possibilities of micro-movements between the two parts. These micro-movements cause the detachment of polyethylene particles which penetrate into the screw holes and come into contact with the bone. This generates osteolysis and, in the long run, loosening of the acetabulum by degradation of the bone-metal contact surface.

Le but de l'invention est de proposer une nouvelle configuration d'implant cotyloïdien pour prothèse totale de hanche, autorisant l'utilisation d'un insert en polyéthylène associé à une cupule métallique, sans les inconvénients précités.The object of the invention is to propose a new configuration of acetabular implant for total hip prosthesis, authorizing the use of a polyethylene insert associated with a metal cup, without the above-mentioned drawbacks.

A cet effet, l'invention a pour objet un insert pour cupule d'implant cotyloïdien pour prothèse articulaire, du type comprenant une coque métallique et un garnissage en polymère de l'espace intérieur de ladite coque, un réceptacle pour une tête prothétique étant ménagé sur le garnissage, ladite coque présentant, sur son espace intérieur, des moyens pour éviter une extraction dudit garnissage hors de la coque et des moyens pour éviter une rotation du garnissage dans la coque, caractérisé en ce que lesdits moyens pour éviter une extraction du garnissage comportent un plot disposé sur le fond de la coque et présentant au moins une rainure ou une lèvre.To this end, the subject of the invention is an insert for an acetabular implant cup cup for a joint prosthesis, of the type comprising a metal shell and a polymer lining of the interior space of said shell, a receptacle for a prosthetic head being provided. on the lining, said shell having, on its interior space, means for preventing extraction of said lining from the shell and means for preventing rotation of the lining in the shell, characterized in that said means for preventing extraction of the lining have a stud disposed on the bottom of the shell and having at least one groove or lip.

Lesdits moyens pour éviter une extraction dudit garnissage peuvent comporter au moins une lèvre.Said means for avoiding extraction of said lining can comprise at least one lip.

Lesdits moyens pour éviter une extraction dudit garnissage peuvent comporter au moins une rainure. Lesdits moyens pour éviter une rotation du garnissage peuvent comporter des bossages ménagés sur la surface de la paroi délimitant l'espace intérieur de la coque.Said means for preventing extraction of said lining may include at least one groove. Said means for preventing rotation of the lining may include bosses formed on the surface of the wall delimiting the interior space of the shell.

Lesdits bossages peuvent être des nervures s'étendant sur toute ou partie de la hauteur de l'espace intérieur de la coque. Lesdits moyens pour éviter une rotation du garnissage peuvent comporter des dépressions ménagées sur la surface de la paroi délimitant l'espace intérieur de la coque.Said bosses may be ribs extending over all or part of the height of the interior space of the shell. Said means for preventing rotation of the lining may include depressions formed on the surface of the wall delimiting the interior space of the shell.

Des bossages peuvent être ménagés sur la lèvre.Bumps can be made on the lip.

Des dépressions peuvent être ménagées sur la lèvre. La partie antérieure de ladite coque peut présenter une conicité.Depressions can be provided on the lip. The front part of said shell may have a taper.

La paroi du réceptacle peut être revêtue de céramique. Ledit garnissage peut être obtenu par une opération de thermocompression dudit polymère dans ledit espace intérieur de la coque suivie par un usinage.The wall of the receptacle can be coated with ceramic. Said lining can be obtained by a thermocompression operation of said polymer in said interior space of the shell followed by machining.

Ledit garnissage peut être obtenu par une mise en forme préalable et être mis en place par impaction dans la coque.Said packing can be obtained by prior shaping and be put in place by impaction in the shell.

L'invention a également pour objet un implant cotyloïdien du type comprenant une cupule destinée à être fixée dans le bassin ou l'omoplate d'un patient et un insert garnissant l'intérieur de ladite cupule pour recevoir une tête prothétique, caractérisé en ce que l'insert est du type précédent. L'invention a également pour objet une prothèse articulaire du type comportant un implant cotyloïdien et une tête prothétique, caractérisée en ce que ledit implant est du type précédent.The invention also relates to an acetabular implant of the type comprising a cup intended to be fixed in the pelvis or the scapula of a patient and an insert lining the interior of said cup to receive a prosthetic head, characterized in that the insert is of the previous type. The invention also relates to a joint prosthesis of the type comprising an acetabular implant and a prosthetic head, characterized in that said implant is of the preceding type.

Comme on l'aura compris, l'invention consiste d'abord à prévoir un insert comportant deux parties : - une coque métallique de base ;As will be understood, the invention firstly consists in providing an insert comprising two parts: - a basic metal shell;

- et une partie en polyéthylène.- and a part in polyethylene.

Des moyens d'ancrage tels que des lèvres et/ou des rainures périphériques et transversales, ménagées dans la coque métallique permettent d'assurer une immobilité totale du polyéthylène dans le métal. On évite ainsi les frottements susceptibles de provoquer un relargage de particules de polyéthylène dans l'environnement de l'insert.Anchoring means such as lips and / or peripheral and transverse grooves, formed in the metal shell make it possible to ensure total immobility of the polyethylene in the metal. This avoids friction which may cause the release of polyethylene particles into the environment of the insert.

Selon, l'invention, un élément essentiel de ces moyens d'ancrage est un plot disposé dans le fond de la coque, et présentant une rainure ou une lèvre. L'invention sera mieux comprise à la lecture de la description qui suit, donnée en référence aux figures annexées suivante :According to the invention, an essential element of these anchoring means is a stud disposed in the bottom of the shell, and having a groove or a lip. The invention will be better understood on reading the description which follows, given with reference to the following appended figures:

- la figure 1 qui montre vu de face (fig.ia) et de dessus (fig.ib) un exemple de coque métallique faisant partie d'un insert pour implant cotyloïdien selon l'invention ;- Figure 1 which shows seen from the front (fig.ia) and from above (fig.ib) an example of a metal shell forming part of an insert for acetabular implant according to the invention;

- la figure 2 qui montre schématiquement et séparément, en perspective et en vue partiellement arrachée, les deux éléments métallique et polymérique d'un exemple d'insert pour implant cotyloïdien selon l'invention. La coque métallique (réalisée généralement en acier inoxydable ou en titane) 1 présente une forme extérieure tronconique (dans l'exemple représenté) ou sphérique dans sa partie postérieure 2, et une forme sensiblement cylindrique dans sa partie antérieure 3. De préférence, comme représenté, cette partie antérieure 3 présente une légère conicité qui, lorsque la cupule est en place dans le bassin ou l'omoplate du patient, contribue au maintien en place de la coque 1. Cette coque 1 est destinée à être mise en place dans un cotyle métallique (non représenté), lui-même fixé dans le bassin ou l'omoplate du patient par scellage ou vissage. L'espace intérieur 4 de la coque 1 , dans l'exemple représenté, est de forme tronconique dans sa partie postérieure 5, et de forme cylindrique dans sa partie antérieure 6. Ces formes pourraient, en variante, être respectivement sphérique (par exemple) et tronconique.- Figure 2 which shows schematically and separately, in perspective and partially cutaway view, the two metallic and polymeric elements of an example of insert for acetabular implant according to the invention. The metal shell (generally made of stainless steel or titanium) 1 has a frustoconical external shape (in the example shown) or spherical in its rear part 2, and a substantially cylindrical shape in its front part 3. Preferably, as shown , this front part 3 has a slight conicity which, when the cup is in place in the patient's pelvis or scapula, contributes to keeping the shell 1 in place. This shell 1 is intended to be placed in a cup metallic (not shown), itself fixed in the patient's pelvis or scapula by sealing or screwing. The interior space 4 of the shell 1, in the example shown, is of frustoconical shape in its rear part 5, and of cylindrical shape in its front part 6. These shapes could, as a variant, be respectively spherical (for example) and tapered.

Le pourtour de la partie antérieure 6 de l'espace intérieur 4 de la coque 1 présente une lèvre en relief 7, elle-même pourvue de dépressions 8 et de bossages 9. Par ailleurs, selon l'invention, le fond 10 de la partie postérieure 5 de l'espace intérieur 4 de la coque 1 présente un plot 11 de forme sensiblement cylindrique, dont la paroi latérale est pourvue d'une rainure 12, comme représenté, et/ou d'une lèvre en relief, ou de plusieurs telles rainures 12 et/ou lèvres.The periphery of the front part 6 of the interior space 4 of the shell 1 has a raised lip 7, itself provided with depressions 8 and bosses 9. Furthermore, according to the invention, the bottom 10 of the part rear 5 of the interior space 4 of the shell 1 has a stud 11 of substantially cylindrical shape, the side wall of which is provided with a groove 12, as shown, and / or a lip in relief, or several such grooves 12 and / or lips.

Selon un mode de réalisation, pour obtenir l'insert pour implant cotyloïdien selon l'invention, on commence par fabriquer une coque métallique du type de celle qui vient d'être décrite. Puis on remplit son espace intérieur par du polyéthylène (ou un autre polymère susceptible de convenir à ce type d'implants) par un procédé de thermocompression, c'est à dire d'injection à chaud sous pression. On fait également déborder le polyéthylène au-delà du bord supérieur 13 de la coque 1. Puis on usine le garnissage 14 en polyéthylène ainsi obtenu de façon à lui conférer une forme qui lui permettra de recevoir la tête de la prothèse de hanche ou d'épaule dont l'implant cotyloïdien selon l'invention fera partie. La figure 2 représente la coque 1 et son garnissage 14 en polyéthylène après usinage. Il doit être compris que ces deux éléments ne sont représentés séparément que pour la commodité de la représentation et que, en réalité, dans ce mode de réalisation le garnissage 14 demeure en permanence dans la coque 1. La lèvre 7 en relief a précisément pour fonction d'empêcher l'extraction du garnissage 14 après sa réalisation, en particulier lors de l'utilisation de l'implant selon l'invention. En effet, au cours de l'opération de thermocompression, il se forme une rainure 15 sur la périphérie extérieure du garnissage 14, au droit de la lèvre 7. La lèvre 7 pénètre donc dans le garnissage 14 et empêche tout mouvement du garnissage 14 qui tendrait à l'extraire de la coque 1.According to one embodiment, to obtain the insert for acetabular implant according to the invention, one begins by manufacturing a metal shell of the type which has just been described. Then its interior space is filled with polyethylene (or another polymer capable of being suitable for this type of implant) by a thermocompression process, that is to say hot injection under pressure. The polyethylene is also made to extend beyond the upper edge 13 of the shell 1. Then the lining 14 is made of polyethylene thus obtained so as to give it a shape which will allow it to receive the head of the hip prosthesis or shoulder of which the acetabular implant according to the invention will form part. FIG. 2 represents the shell 1 and its lining 14 made of polyethylene after machining. It should be understood that these two elements are shown separately only for the convenience of representation and that, in In reality, in this embodiment, the lining 14 remains permanently in the shell 1. The raised lip 7 has precisely the function of preventing the extraction of the lining 14 after it has been produced, in particular when using the implant according to the invention. In fact, during the thermocompression operation, a groove 15 is formed on the outer periphery of the lining 14, in line with the lip 7. The lip 7 therefore penetrates into the lining 14 and prevents any movement of the lining 14 which would tend to extract it from the shell 1.

Le plot 11 possède une fonction analogue. Lors de la thermocompression, le polyéthylène vient se mouler autour de lui, et la présence de la rainure 12 (respectivement d'une lèvre) procure une possibilité d'accrochage du garnissage 14 sur le plot 11 , par formation sur le garnissage 14 d'une lèvre en relief 16 (respectivement d'une rainure) au droit de la rainure 12 (respectivement de la lèvre) du plot 11. La présence de ce plot 11 procure une résistance entièrement efficace à l'extraction du garnissage 14 et complète l'effet des autres éléments anti-extraction. Il peut même éventuellement constituer le seul élément anti-extractionThe stud 11 has a similar function. During thermocompression, the polyethylene is molded around it, and the presence of the groove 12 (respectively of a lip) provides a possibility of attachment of the lining 14 on the stud 11, by formation on the lining 14 of a raised lip 16 (respectively of a groove) in line with the groove 12 (respectively of the lip) of the pad 11. The presence of this pad 11 provides fully effective resistance to the extraction of the lining 14 and completes the effect of other anti-extraction elements. It can even possibly constitute the only anti-extraction element

Quant aux mouvements de rotation du garnissage 14 à l'intérieur de la coque 1 , ils sont empêchés par les dépressions 8 et les bossages 9 ménagés sur la lèvre 7.As for the rotational movements of the lining 14 inside the shell 1, they are prevented by the depressions 8 and the bosses 9 formed on the lip 7.

De cette façon, les mouvements du garnissage 14 dans la coque 1 sont bloqués avec une efficacité optimale dans toutes les directions de l'espace. On évite ainsi que de tels mouvements ne provoquent un déplacement et une érosion du garnissage 14. La configuration qui a été décrite et représentée pour les moyens autres que le plot 11 destinés à empêcher les déplacements du garnissage 14 dans la coque 1 et hors de la coque 1 n'est qu'un exemple.In this way, the movements of the lining 14 in the shell 1 are blocked with optimum efficiency in all directions of space. This prevents such movements from causing displacement and erosion of the lining 14. The configuration which has been described and shown for means other than the stud 11 intended to prevent displacements of the lining 14 in the shell 1 and out of the shell 1 is just one example.

La lèvre 7 peut être continue sur toute la périphérie de l'espace intérieur 4 de la coque 1 , ou être discontinue. Il peut y en avoir plusieurs, réparties à différents niveaux de l'espace intérieur 4 de la coque 1. Elle pourrait être remplacée par une ou plusieurs rainures qui créeraient un relief correspondant sur le garnissage 14 lors de la thermocompression. Toutefois la lèvre 7 est la configuration préférée pour les moyens anti-extraction autres que le plot 11. En effet le polyéthylène, après la thermocompression, subit un retrait de 1 ,8%. Ce retrait tend à renforcer l'accrochage du garnissage 14 sur la coque 1 si celle-ci présente une lèvre 7, alors qu'une rainure tendrait à dégrader cet accrochage. Bien entendu, lèvres et rainures peuvent être combinées. Cet effet de renforcement de l'accrochage par le retrait du polyéthylène est également très sensible au niveau du plot 11 , et, justement, la forme du plot 11 permet de tirer parti de cet effet de manière optimale.The lip 7 can be continuous over the entire periphery of the interior space 4 of the shell 1, or be discontinuous. There may be several, distributed at different levels of the interior space 4 of the shell 1. It could be replaced by one or more grooves which would create a corresponding relief on the lining 14 during thermocompression. However the lip 7 is the preferred configuration for the anti-extraction means other than the stud 11. In fact the polyethylene, after thermocompression, undergoes a shrinkage of 1.8%. This withdrawal tends to strengthen the attachment of the lining 14 to the shell 1 if the latter has a lip 7, while a groove would tend to degrade this attachment. Of course, lips and grooves can be combined. This effect of strengthening the attachment by the withdrawal of the polyethylene is also very sensitive at the level of the pad 11, and, precisely, the shape of the pad 11 makes it possible to take advantage of this effect in an optimal manner.

En ce qui concerne les moyens anti-rotation, on peut ne prévoir que des dépressions 8, ou que des bossages 9, et les ménager à d'autres endroits que la lèvre 7 sur la surface de la paroi délimitant l'espace intérieur 4 de la coque 1. Pour la même raison que précédemment, liée au retrait du polyéthylène, les bossages 9 sont privilégiés. Ils peuvent avoir la forme de nervures s'étendant sur tout ou partie de la hauteur de l'espace intérieur 4 de la coque 1. Comme on le voit sur la figure 2, l'usinage du garnissage 14 après la thermocompression permet de ménager d'une part un rebord 17 reposant sur le bord supérieur 13 de la coque 1 , et surtout un réceptacle 18 de forme sphérique destiné à recevoir des têtes de différentes matières (céramiques ou métalliques) de la prothèse de hanche ou d'épaule à laquelle l'implant cotyloïdien selon l'invention est destiné à être intégré.As regards the anti-rotation means, it is possible to provide only depressions 8, or only bosses 9, and to arrange them in places other than the lip 7 on the surface of the wall delimiting the interior space 4 of the shell 1. For the same reason as previously, linked to the withdrawal of the polyethylene, the bosses 9 are preferred. They may have the form of ribs extending over all or part of the height of the interior space 4 of the shell 1. As can be seen in FIG. 2, the machining of the lining 14 after thermocompression makes it possible to spare d on the one hand a rim 17 resting on the upper edge 13 of the shell 1, and above all a receptacle 18 of spherical shape intended to receive heads of different materials (ceramic or metallic) from the hip or shoulder prosthesis to which the the acetabular implant according to the invention is intended to be integrated.

En variante on peut également incorporer, notamment par thermocompression, un revêtement céramique dans le réceptacle 18. De cette façon le contact entre l'insert et la tête de la prothèse, si celle-ci est en céramique, est un contact céramique-céramique qui évite tout relargage de polyéthylène dans l'environnement de la prothèse.As a variant, it is also possible to incorporate, in particular by thermocompression, a ceramic coating in the receptacle 18. In this way the contact between the insert and the head of the prosthesis, if the latter is ceramic, is a ceramic-ceramic contact which avoids any release of polyethylene into the environment of the prosthesis.

Dans un autre mode de réalisation, le garnissage 14 est réalisé non par thermocompression dans la coque 1 , mais par une opération de mise en forme (moulage et/ou usinage par exemple) effectuée en dehors de la coque 1. La mise en place du garnissage 14 dans la coque 1 est ensuite effectuée par impaction dans la coque 1 , le garnissage 14 présentant des creux et reliefs complémentaires des reliefs et creux présents sur l'espace intérieur 4 de la coque 1. Eventuellement, un dernier usinage du garnissage 14 après sa mise en place permet, si nécessaire, d'en ajuster les dimensions extérieures. Là encore, un revêtement céramique peut être ajouté dans le réceptacle 18. In another embodiment, the lining 14 is produced not by thermocompression in the shell 1, but by a shaping operation (molding and / or machining for example) carried out outside the shell 1. The positioning of the lining 14 in the shell 1 is then carried out by impaction in the shell 1, the lining 14 having hollows and reliefs complementary to the reliefs and hollows present on the interior space 4 of the hull 1. Optionally, a final machining of the lining 14 after its setting place allows, if necessary, to adjust the external dimensions. Again, a ceramic coating can be added to the receptacle 18.

Claims

REVENDICATIONS 1. Insert pour cupule d'implant cotyloïdien pour prothèse articulaire, du type comprenant une coque (1) métallique et un garnissage (14) en polymère de l'espace intérieur (4) de ladite coque (1), un réceptacle (18) pour une tête prothétique étant ménagé sur le garnissage (14), ladite coque présentant, sur son espace intérieur (4), des moyens pour éviter une extraction dudit garnissage (14) hors de la coque (1) et des moyens pour éviter une rotation du garnissage (14) dans la coque (1), caractérisé en ce que lesdits moyens pour éviter une extraction du garnissage comportent un plot (11) disposé sur le fond (10) de la coque (1) et présentant au moins une rainure (12) ou une lèvre.1. Insert for cup of acetabular implant for joint prosthesis, of the type comprising a metal shell (1) and a lining (14) in polymer of the interior space (4) of said shell (1), a receptacle (18) for a prosthetic head being formed on the lining (14), said shell having, on its interior space (4), means for preventing extraction of said lining (14) from the shell (1) and means for preventing rotation of the lining (14) in the shell (1), characterized in that said means for preventing extraction of the lining comprise a stud (11) disposed on the bottom (10) of the shell (1) and having at least one groove ( 12) or a lip. 2. Insert selon la revendication 1 , caractérisé en ce que lesdits moyens pour éviter une extraction dudit garnissage (14) comportent au moins une lèvre (7). 2. Insert according to claim 1, characterized in that said means for preventing extraction of said lining (14) comprise at least one lip (7). 3. Insert selon la revendication 1 ou 2, caractérisé en ce que lesdits moyens pour éviter une extraction dudit garnissage (14) comportent au moins une rainure.3. Insert according to claim 1 or 2, characterized in that said means for preventing extraction of said lining (14) comprise at least one groove. 4. Insert selon l'une des revendications 1 à 3, caractérisé en ce que lesdits moyens pour éviter une rotation du garnissage (14) comportent des bossages (9) ménagés sur la surface de la paroi délimitant l'espace intérieur (4) de là coque (1).4. Insert according to one of claims 1 to 3, characterized in that said means for preventing rotation of the lining (14) comprise bosses (9) formed on the surface of the wall defining the interior space (4) of there shell (1). 5. Insert selon la revendication 4, caractérisé en ce que lesdits bossages (9) sont des nervures s'étendant sur toute ou partie de la hauteur de l'espace intérieur (4) de la coque (1). 5. Insert according to claim 4, characterized in that said bosses (9) are ribs extending over all or part of the height of the interior space (4) of the shell (1). 6. Insert selon l'une des revendications 1 à 5, caractérisé en ce que lesdits moyens pour éviter une rotation du garnissage (14) comportent des dépressions (8) ménagées sur la surface de la paroi délimitant l'espace intérieur (4) de la coque (1).6. Insert according to one of claims 1 to 5, characterized in that said means for preventing rotation of the lining (14) include depressions (8) formed on the surface of the wall delimiting the interior space (4) of the shell (1). 7. Insert selon les revendications 2 et 4 prises ensemble, caractérisé en ce que des bossages (9) sont ménagés sur la lèvre (7).7. Insert according to claims 2 and 4 taken together, characterized in that bosses (9) are provided on the lip (7). 8. Insert selon les revendications 2 et 6 prises ensembles, caractérisé en ce que des dépressions (8) sont ménagées sur la lèvre (7). 8. Insert according to claims 2 and 6 taken together, characterized in that depressions (8) are provided on the lip (7). 9. Insert selon l'une des revendications 1 à 8, caractérisé en ce que la partie antérieure de ladite coque (1) présente une conicité.9. Insert according to one of claims 1 to 8, characterized in that the front part of said shell (1) has a taper. 10. Insert selon l'une des revendications 1 à 9, caractérisé en ce que la paroi du réceptacle (18) est revêtue de céramique. 10. Insert according to one of claims 1 to 9, characterized in that the wall of the receptacle (18) is coated with ceramic. 11. Insert selon l'une des revendications 1 à 10, caractérisé en ce que ledit garnissage (14) est obtenu par une opération de thermocompression dudit polymère dans ledit espace intérieur (4) de la coque (1) suivie par un usinage.11. Insert according to one of claims 1 to 10, characterized in that said lining (14) is obtained by a thermocompression operation of said polymer in said interior space (4) of the shell (1) followed by machining. 12. Insert selon l'une des revendications 1 à 10, caractérisé en ce que ledit garnissage (14) est obtenu par une mise en forme préalable et en ce qu'il est mis en place par impaction dans la coque (1).12. Insert according to one of claims 1 to 10, characterized in that said lining (14) is obtained by a prior shaping and in that it is put in place by impaction in the shell (1). 13. Implant cotyloïdien du type comprenant une cupule destinée à être fixée dans le bassin ou l'omoplate d'un patient et un insert garnissant l'intérieur de ladite cupule pour recevoir une tête prothétique, caractérisé en ce que l'insert est du type selon l'une des revendications 1 à 12. 13. Cotyloid implant of the type comprising a cup intended to be fixed in the pelvis or the scapula of a patient and an insert lining the interior of said cup to receive a prosthetic head, characterized in that the insert is of the type according to one of claims 1 to 12. 14. Prothèse articulaire du type comportant un implant cotyloïdien et une tête prothétique, caractérisée en ce que ledit implant est du type selon la revendication 13. 14. Joint prosthesis of the type comprising a cotyloid implant and a prosthetic head, characterized in that said implant is of the type according to claim 13.
PCT/FR2004/001410 2003-06-06 2004-06-07 Insert for a cotyloid implant cup for a joint prosthesis, cotyloid implant and joint prosthesis Ceased WO2004110318A2 (en)

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DE602004004115T DE602004004115T2 (en) 2003-06-06 2004-06-07 USE OF A COTYLOID IMPLANT PULP FOR A JOINT PROSTHESIS, COTYLOID IMPLANT, AND JOINT PROSTHESIS
US10/559,680 US8556984B2 (en) 2003-06-06 2004-06-07 Insert for a cotyloid implant cup for a joint prosthesis, cotyloid implant and joint prosthesis
EP04767276A EP1631219B1 (en) 2003-06-06 2004-06-07 Insert for a cotyloid implant cup for a joint prosthesis, cotyloid implant and joint prosthesis

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FR03/06893 2003-06-06
FR0306893A FR2855743B1 (en) 2003-06-06 2003-06-06 COTYLOID IMPLANT CUP INSERT FOR JOINT PROSTHESIS, COTYLOID IMPLANT AND ARTICULAR PROSTHESIS

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EP (1) EP1631219B1 (en)
AT (1) ATE349979T1 (en)
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FR2855743A1 (en) 2004-12-10
DE602004004115D1 (en) 2007-02-15
US8556984B2 (en) 2013-10-15
ATE349979T1 (en) 2007-01-15
ES2278340T3 (en) 2007-08-01
WO2004110318A3 (en) 2005-02-17
EP1631219A2 (en) 2006-03-08
EP1631219B1 (en) 2007-01-03
US20060276905A1 (en) 2006-12-07
FR2855743B1 (en) 2006-02-10

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